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Author Topic: Advice-Daughter's softball injury  (Read 1499 times)

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Offline Ihave3kids

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Advice-Daughter's softball injury
« on: January 28, 2005, 01:26:26 AM »
Hi all,
So glad I found this board and you all have some great advice. Hope you can help me. I'm just sitting in tears right now...anger, frustration, sadness. I don't want to make this too long but need to give all the information, hoping someone out there can tell me what to do next.

My 13 year old daughter was practicing softball over Thanksgiving vacation (2004). We were on a winning streak so coach wanted to practice and practice hard. My daugther is one of the fastest and best sliders on the team. He had them running hard and sliding into home plate.
Picture this....
She was running really fast, right leg out, left leg starting to bend inward, went into the slide too early then her right foot cleat dug into the ground bringing her almost to a stop then twisting the foot one way and the knee another..THEN..coming to a complete stop, front inside of knee jammed into the ground--I know this because of the huge wound area.

It swelled up like a balloon right away, she couldn't walk, her calf & top of knee starting turning black and blue. Immediately put ice and gave Motrin. Pain was so bad it hurt for her to be carried to the car, with thought of something broken we hauled her to the emergency room. X-rays showed no breaks-whew! Physician said it's a bad sprain. Gave a half cast splin, told to wrap it, take Motrin and in 3 days the pain should go away. See doctor if you want to.

Well....pain never subsided. In 3 days the pain was still so bad she could barely limp to the bathroom. She didn't sleep but 5 hours in 3 days.  Her foot started going numb, black & blue and turned cold...that crept up to her calf by the 4th day. GP ordered MRI while waiting for the $#@& insurance authorization for orthopedist. Went to school on crutches...what a mistake, knee swelled up like a balloon again. Kept her off school for 1 week.

Finally saw an orthopedist 1 month later. By this time she's limping but able to get to school without crutches. Everyday she comes home, elevates it and puts ice..then it's fine again until the next day. She said from day #3 that there is no clicking but when she tries to stand it feels weird and acts like it just flops around to where she might fall. Pain is still (and always has been) to the inside, around the inside. Some pain with movement to the top of the knee but not all the way around.  She tells him that her knee looks funny and out of place.  All her friends say her knee looks funny and sideways. He says it's OK.

Ortho briefly looks at MRI and says it's the best MRI he's seen in months, report says everything is fine. Sends us off with some thigh strenghtening excercises and says it should be OK in a few weeks. He agrees it's just a bad sprain. No running for 3 weeks.

Last week she was accepted for a major softball team but can't run. I made an appointment on Monday. Ortho is stumped. Says MRI looks good, can't figure out why there is pain.Ortho says it's not the ACL or Meniscus.  He leaves the room and comes back 3 times...every time looking confused. Finally starts checking some things and now says that...although the MRI shows me that the patella is perfectly lined up (I didn't see it but OK) she may have dislocated the patella but it's healing nicely. He moved her knee cap around and pushed it until she said "that feels better" then tells me she needs a patellar knee stabilizer without hinges. Says physical therapy will not help, if anything moving it will make it worse. Says it will heal with time. Can't tell me why it's swelling, take motrin for pain.

She's very tall and thin. I tried on several (3 stores) stabilizers and none are comfortable standing let alone walking or running. We tried wrapping it while pushing the patella into place and no luck. Too uncomfortable and the patella just goes back, causing pain. She tried batting with the team on Monday and some slight (fast walking) to get the ball and NO WAY...knee was swollen within 1 hour. Today is Thursday and it's swollen just limping around school.

Unfortunately, I can't see another orthopedist because I have crappy insurance and he's the only one in my HMO network. Wish I could afford a better doc but I can't---gotta love those expensive American doctors!!!!

Now my daughter is in tears and hysterical because softball is her life and the thought of giving it up is killing her (it's killing me too but trying not to let it show) her Dad is the assistant coach and thinks it will get better the season start...uh, NO..it starts in 4 weeks!!!!!!!!!!! I explained to her today that she's only 13 and has the rest of her life with that knee, one season of no softball wouldn't hurt (she wailed like I asked her to give an arm away) and let it heal properly. Told her I would call and explain it to the coach, that he'd understand......After 20 min. of tears and hysteria I agreed to let her try with the team.

Gawd, I'm turning into one of those sports mother's that I said I would never become...letting my child play while injured!! I'm sooooo at a loss of what to do.

Anyone have advice? Anyone have any idea what this could be? Is it true that this doctor should NOT rely on the MRI? Should I have him open her up and look before it's too late? Anyone think I should just wait it out and hope it heals properly? Anyone out there think it's more than a bad sprain or is that what it is?

Anyone feeling my frustration level reaching it's boiling point? Thanks for all the help!

Offline ATsoccergirl

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Re: Advice-Daughter's softball injury
« Reply #1 on: January 28, 2005, 01:41:36 AM »
Hey,

I'm a certified athletic trainer with a lot of experiance with softball players. 

I will almost never say this, but her OS is wrong.  Physical therapy is more than indicated in her case.  If her knee cap dislocated, PT is essential in order to strength the muscles around the joint to prevent it from happening again.  They will also be able to potentially tape her knee cap which would mimic the brace.  This would save you the hassle of finding one unless you are sure it will really help.  Most PT clinics will also be able to order the proper brace.  A good PT will be able to give you a better clue of what is actually happening with her knee. 

There is something obviosly not right still.  A second opinion is really indicated here.  If money is an issue, you might want to check with big orthopedic groups in your area and see if they have a free clinic for athletes.  They will normally only have you pay for x-rays if they indicated, you could even bring the x-rays from the ER to cut down on the expense.

Feel free to e-mail if you want, my address is in my profile.

1999 LR, 2002 ACL/PLC recon, reversal of LR, 2004 ACL revision, 2006 Car accident torn PCL and small fractures resulting in bone chips in my knee.  Torn MCL 3 times.  Wicked screws under IT band and Pes Anserine.  June 2008-Hip Arthroscopy.

Offline mhsflute07

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Re: Advice-Daughter's softball injury
« Reply #2 on: January 28, 2005, 03:03:45 AM »
Hi!
I'm so sorry to hear about your daughter. I'm 16 and have dislocated both kneecaps many times. It is devastating to not be able to do something you love because of something you can't do anything about. 
I agree with ATsoccergirl about the PT. PT may not fix the problem, but it could very well strengthen the knee enough to where she can participate and avoid surgery. I have been to PT many times over the past 5 years and that is probably why I have been able to put off surgery and keep playing tennis.
Bracing or taping may also help. I wear DonJoy TruPull braces on both my knees and they are comfortable to wear for tennis and even all day use when needed. http://www.donjoy.com
I would also get a second opinion, if at all possible. I am currently on my 4th orthopedist. This is the first one to actually explain exactly why my knees are the way they are and tell me what he can do to fix it. If you can't get a prescription for PT from the orthopedist, maybe your GP can give you one....mine did. This way you can have someone else look at her knee. I have found that PTs are more willing to work with, explain, and listen to you. Also, if your daughter's school has an athletic trainer, maybe he/she would be will to help you/her.
I hope this helps some. Feel free to email me as well. I don't think it is listed in my profile, so it is [email protected]
~Erin~
June 2, 2005 TTT/LR  R.
July 26, 2005 TTT/LR  L.
June 6, 2006 Microfracture R.
June 5, 2007 Microfracture & Screw Removal R.
March 12, 2009 Scope and ACI Biopsy R.
May 12, 2009 TTT, Trochleoplasty R.
December 15, 2009 ACI (patella) & bilateral hardware removal
December 21, 2010 LOA and LR

Offline Heather M.

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Re: Advice-Daughter's softball injury
« Reply #3 on: January 28, 2005, 07:02:58 AM »
I would strongly suggest you listen to ATSoccergirl. This is based on her experience...and my experience with an HMO.  Keep in mind that the objective of the HMO is to MANAGE health care costs.  They do this by consistently refusing to make expenditures, except in the case of an open wound or horrific fracture or something.  As long as the patient is ambulatory, they will decline treatments. 

I injured myself doing yoga, and tried to treat things myself for 4 months--I did Rest, Ice, Compression, and Elevation (RICE) faithfully.  I didn't get better.  I finally got my GP (after two months of declining it!) to refer me to an orthopedic surgeon on my HMO list.  In the waiting room, no joke, there were four 80 year old women on walkers who had had knee replacements.  So of course the surgeon says "your knee doesn't look so bad."  He then said that if "running, aerobics, hiking, and walking my dog" hurt my knee, then I shouldn't do them.  Consultation over.

I went out of network and saw a sports medicine oriented orthopedic surgeon.  He did an exam and said he felt I'd torn my meniscus, potentially had a cyst or growth in the knee, and that I had a lot of damage to the articular cartilage (chondromalacia).  He said the only solution was surgical, since I'd been doing RICE and all of my previous physical therapy exercises (having had a bad knee for close to 20 years at this point).  He sent me for an MRI to verify, and he was exactly right in each of his diagnoses.  I had surgery 5 days later.  My poor out come was unrelated to the meniscal tear and more a result of having poor knee mechanics and having abused my knees since I was 13.

Anyway, your daughter needs another opinion.  It's not just a softball season, it's the health of her knee.  A torn ACL (which sounds possible given the mechanism of her injury) can lead to serious instability and future meniscal injuries.  This in turn can end in premature osteoarthritis.  Talk to people on this board who didn't have their ACL's repaired, and I would imagine 90% of them seriously regret that decision.  Some made it based on HMO's or cheap government healt care policies.  So don't let the insurance company you deal with determine your daughter's future quality of life.  Osteoarthritis really, really stinks.  It's painful, and there is very little at this point that surgeons can do when a young person appears with this condition.

Read through the posts on this board and hoepfully learn some about knees.

Here's a good link--my surgeon's web page.  He's a very highly respected doctor and people travel from around the world to see him.  Most are athletes.  Read throught the various knee topics--ACL, meniscus, chondral defect (which can happen with a dislocation), and PFS (which is poor knee mechanics and tracking, due to injury or genetics, as in my case).  The language is very easy to understand, and the diagrams will help make things crystal clear.
http://www.steadman-hawkins.com/patientEducation.asp   

Honestly, if my family were involved I would not let some pencil-pushing accountant working in a cubicle at the headquarters of my HMO determine what is right for my loved ones!!  Your instincts seem to be saying something is wrong, and I would listen to those ANY DAY over the rules and policies of the HMO.  Their job is to keep costs to an absolute minimum, not to provide top of the line health care to their customers.  Cost containment first, and they do this by allowing a pretty standard treatment and diagnostic regimen that works okay for 90% of their patients.  God help the remaining 10%.  I had to go outside the system to get my knee cleaned up.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline AndrewC

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Re: Advice-Daughter's softball injury
« Reply #4 on: January 28, 2005, 09:09:03 AM »
HI there Ihave2kids!

Sounds like a tough situation for your daughter (and you).
I have to totally agree with the other posters in that a 2nd opinion by a KNEE SPECIALIST is really needed here. I don't know too much about the US healthcare system as I am from the UK but I have heard about HMO's. Is there any way you could change plan or insurer or whatever in order to get to be able to see a knee specialist? Was the first OS you saw a general orthopaedist or a knee specialist who only does knees?? If not you really do need to see a well known specialist.

I don't know how it works over there but could you not pay for a private consult like you can here in the UK if your insurance doesnt cover it?? That way you can see a good surgeon and at least get a Proper diagnosis if not treatment. This would offer a lot of peace of mind I believe.

FInally, I would NOT use the first surgeon for any type of surgery without at least getting a 2nd opinion to verify his diagnosis and "treatment" (which incidentally is as the first poster says...wrong...for a patellar dislocation Physio should be a primary factor in recovery). As HeatherM says (and a lot of people here know well!) knees are for life (except TKRs  ;D) and your daughter will have to live with the consequences of your OS's actions and treatment. Thats why its so vital to find a GOOD surgeon...because very often incorrect or even poor surgery can affect a persons recovery for ever (and sometimes ruin it).

If you need to know of some surgeons who are well known in your area people on this site should be able to help you or check out the knee surgeons link at the top of the page and follow it to your area.

Good Luck and keep us posted
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline spartanpele

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Re: Advice-Daughter's softball injury
« Reply #5 on: January 28, 2005, 01:25:10 PM »
Wow... I'm so sorry to hear about your daughters knee problems.  As everyone else so far has indicated...you need to get a 2nd opinion.  I don't think you can just assume that everything will heal.  You need confidence in your doctor, PT, trainer, etc, that things are progressing, and it doesn't sound like you have that right now.

I think the prior posters have put you on the right track for that...so now I'll offer some free advice on related items: your daughter, sports, your husband coaching, athletics.

I've been coaching high school aged kids for over a decade and I can safely say that your daughters health should come first before any game.  No matter how important your daughter or husband might think the game is, sorry, but her healthy s/b the top priority. 

Until she can go through all the normal strength, range of motion, balance, cutting, sprinting, etc, she shouldn't be participating.  She can still be with the team and be supportive of her teammates and father while rehabbing, but she shouldn't be in a regular game before shes healthy.  I personally know many players who wanted to "play through the pain" because they love sports, or because of parental pressure...but its not worth the possible long term effects she could have if she plays before shes ready.

You said you didn't want to be one of those parents who lets her child play injured..right?   Shes only 13, and at that age (my daughter is now 19 and off to college...so I had plenty of years of girl wailing experience), everything is a "you're runing my life type of ordeal".   

As for her coach...if he/shes a person of character...they'll understand and put her health first!  Because lets face it...years from now, nobody is going to really remember those games, the standings, or any old trophy...however...SHE will remember her injury if its still bugging her later in life.

Offline Janet

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Re: Advice-Daughter's softball injury
« Reply #6 on: January 28, 2005, 07:50:28 PM »
Not only that, but I wouldn't want my daughter to play for a coach that allowed her to play injured. My daughter was supposed to play softball in college, but tore her MCL 6 weeks before school started. While they gave her extra time to rehab, she was not able to fully rehab in time to play the first year. She wanted to play, but her trainer and her coach would not let her. It was the best decision....but it was hard, with lots of tears on all sides.

But now life goes on. Because she didn't play softball, she got interested in other things. She was able to spend a semester in Spain, which she couldn't have done with softball. It has been three years, and she no longer regrets losing softball.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline allstardiva2005

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Re: Advice-Daughter's softball injury
« Reply #7 on: January 28, 2005, 09:13:49 PM »
I would get a 2nd opinion and let her heal before returning to softball. If you let her play, she could always do more damage that could lead to worse conditions down the road. Instead of missing part of a season or even one, she could miss more if the injury is not addressed and she makes it worse.

She's only 13- you want her to be able to be athletic for the rest of her life, not just in high school. I wish I had taken things slower with recovery. I first partially tore my ACL and medial meniscus in July of 2000 playing basketball. My OS decided to wait to repair my ACL until I completely tore it in 2002. I'm having surgery #6 on Valentine's Day and they have no idea if I'll ever be able to run again- something very hard for a varsity track captain. I'm just saying it's going to be harder for your daughter, but in the long run- it'll be better to let her heal first and definately see another surgeon and get his opinion.

Christy
Medial Meniscus Repair- '00,03
Partial Meniscectomy- '03, '04
ACL Reconstruction- '02
Exploratory Scope- '05
Allograft ACL Revision & Neuroma Excision- '06
Hardware Removal & Bone Filing- '06
Scar Tissue Removel- '07

** Medial meniscus transplant is in the near future... **

Offline Ihave3kids

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Re: Advice-Daughter's softball injury
« Reply #8 on: January 31, 2005, 03:41:14 AM »
Hi Everyone,

Thanks sooooo much for all the great advice. I called my primary care doctor and talked to the nurse. I explained what the OS said and what you all told me. She said sounds like he's not sure and sounds strange to her as well.

She is calling to see if I can get a second opinion direct referral since it involves "pain"  I sure hope so.

We tried on more knee braces this weekend and NONE were comfortable. Plus the fact we couldn hold the knee cap in place, cinch it down and have the knee cap stay where it should. Sounds like the taping is what is needed.

I also called a sports clinic and they were suppose to call me back, but never did. I'm going to try again tomorrow.

I've included some pics of my daughter's knees(hope it works). I know you can't diagnosis with pics but thought I'd include them. Does anyone see anything?
Please don't mind the tom-boy scarred knees....teehee! The right knee (the injured knee) has a fresh scar which is obvious but the discoloration and scarring on the bottom are also from the accident.


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